要方第九卷所治如下∶
治服寒食散方
治寒食散发动诸方
治服传病诸决(待考)
上三件
服草木之药则速发,须调饮食;金石者则迟起而难息。其始得效者,皆是草木盛也,金
石乃延引日月。草木少时便息,石势犹自未盛。其有病者不解消息,便谓顿休,续后更服,
或得病固药微,倍复增石,或便杂服众石,非一也。石之为性,其精华之气,则合五行,乃
益五脏,其浊秽便同灰土。但病家血气虚少,不能宣通更陈瘀,便成坚积。若其精华气不发,
则冷如冰。而病者服之望石入腹即热,既见未热,
服之弥多。既见石不即效,便谓不得其力,至后发动之日,都不自疑是石,不肯作石消
息,便作异治者,多致其害。
道弘道人制《解散对治方》,说草石相对之和,有的能发动为证,世人逐易,不逆思寻
古今方说,至于动散,临急便就服之,即不救疾,便成委祸。大散由来早难将之药,夫以大
散难将,而未经服者,乃前有慎耳。既心期得益,苟就服之,已服之人,便应研习救解之宜,
异日动之,便得自救也。夫身有五石之药,而门内无解救之人,轻信对治新方,逐易服之,
从非弃是,不当枉命误药邪?检《神农本草经》,说草石性味,无对治之和,无指的发动之
说,
按其对治之和,亦根据本草之说耳。且大散方说主患,注药物,不说其所主治,亦不说对和指
的发动之性也。览皇甫士安撰《解散说》及将服消息节度,亦无对和的发之说也。复有禀丘
家,将温法以救变败之色,亦无对和的动之说。若以药性相对为神者,栝蒌恶干姜,此是对
之大害者。道弘说对治而不辨此,道弘之方焉可从乎?今不从也。当从皇甫节度,自更改栝
蒌,便为良矣。患热则不服其药,惟患冷者服之耳,自可以除栝蒌。若虚劳脚弱者,以石斛
十分代栝蒌;若风冷上气咳者,当以紫苑十分代栝蒌。二法极良。若杂患常疾者,止除栝蒌
而已,慎勿加余物。
《小品方》第九卷所记载的治疗内容如下:
治疗服用寒食散的方剂。
治疗寒食散发作引发的各种病症的方剂。
治疗服用后传变疾病的各种决断(待考证)。
以上三项。
服用草木类药物则药力容易发动,需要调理饮食;服用金石类药物则药力起得慢但难以平息。那些刚开始见效的,都是因为草木类药性猛烈所致,而金石类药物则是拖延时日才显现作用。草木类药物在少量时就能平息,但石药的药势却仍然没有达到旺盛程度。如果有患病的人不懂得调节和观察药情,就以为病已经一次性痊愈了,随后又继续服药,有的因为病情顽固而药物轻微,便加倍增加石药的分量,有的甚至混杂服用多种石药,不止一种。石药的性质,其精华之气能够配合五行,从而补益五脏,但其浑浊秽浊的部分则如同灰土一般。只是病人血气虚弱,不能宣通代谢掉体内的瘀滞,就会形成坚硬的积块。如果石药的精华之气不发动,身体就会冷得像冰一样。而病人服用后期望石头进入腹部就产生热感,既然见到没有发热,反而服用的更多。既然见到石头没有立即见效,就认为它不得力,到了后来药力发作的日子,完全不怀疑是石药引起的,不肯按照石药的方法来消除药毒,而是采取其他治疗方法,这大多会导致危害。
道弘道人制定了《解散对治方》,论述草木与石药相对抗时的调和方法,确实有些能作为药力发动的验证,世人争相改变旧法,不逆向思考探寻古今方书的说法,等到散药发作时,临急便去服用这些新方,结果不仅救不了疾,反而招致祸患。大寒食散向来就是难以调养的药剂,正因为大寒食散难养,所以未曾服用过的人,之前是因为谨慎罢了。既然心里期望得到益处,勉强就去服用,已经服用的人,就应该研习解救的方法,以便日后药力发作时能够自救。身上服用了含有五种石头的药物,而门内却没有懂得解救的人,轻信对治的新方,争相改变并服用,这是舍弃正确的而追随错误的,难道不是枉送性命、误用药物吗?查阅《神农本草经》,论述草木和石药的性味,没有关于对治调和的说法,也没有明确指出发动的药理。按照其对治调和的理论,也是依据本草经的说法罢了。况且大寒食散的方子主要说明主治病症,注释药物,却不说明其所主治的具体机理,也不说明对治调和及明确发动的性质。浏览皇甫士安撰写的《解散说》以及调养服用的调节节度,也没有关于对治调和发动的说法。又有禀丘家,用温法来救治因药败变坏的颜色,也没有对治调和发动的说法。如果把药性相对立当作神妙之法的,比如栝蒌畏干姜,这是对治中的大害处。道弘论述对治却不辨析这一点,道弘的方子怎么能听从呢?现在我不听从。应当遵循皇甫谧的节度,自行更改去除栝蒌,这样就很好了。患有热症的人不服用该药,只有患冷症的人才服用它,自然可以去除栝蒌。如果是虚劳脚弱的人,用十分石斛代替栝蒌;如果是风冷上气咳嗽的人,应当用十分紫菀代替栝蒌。这两种方法极好。如果是杂病常疾的人,只需去除栝蒌而已,千万不要添加其他东西。
The treatments recorded in Volume 9 of *Xiaopin Fang* are as follows:
Formulas for treating the administration of Hanshi San (Cold Food Powder).
Formulas for treating various conditions triggered by the activation of Hanshi San.
Various judgments for treating diseases transmitted after administration (to be verified).
The above three items.
Administration of herbal medicines (Caomu) causes rapid activation, requiring dietary regulation; administration of mineral and metallic substances (Jinshi) has a slow onset but is difficult to subside. Those who initially see effects are due to the potency of herbal medicines, whereas mineral substances prolong the process over days and months. Herbal medicines subside when used in small amounts, while the momentum of stone drugs remains unfulfilled. Patients who do not understand how to regulate and observe the drug's condition may mistakenly believe the illness has ceased entirely, leading them to continue taking medicine. Some, finding the illness stubborn and the medication mild, double the dosage of stone drugs; others mix various types of stones indiscriminately. The nature of stone drugs: their essence and qi harmonize with the Five Elements, thereby benefiting the Zang-Fu organs (internal organs), while their turbid and impure parts resemble ash and soil. However, if the patient's blood and Qi are deficient and unable to circulate and eliminate stasis, hard accumulations form. If the essence and qi of the stone drugs do not activate, the body becomes cold as ice. Yet patients expect heat upon ingestion of the stones; seeing no immediate heat, they increase the dosage. Seeing no immediate effect, they deem the drug ineffective. When the drug eventually activates later, they fail to suspect it is caused by the stones and refuse to treat it according to protocols for dissipating stone toxins, opting instead for other therapies, which often leads to harm.
Dao Hong Daoren formulated the *Sanjie Duizhi Fang* (Formula for Counteracting Dissipation), discussing the harmony between opposing herbs and minerals. Although some cases serve as evidence of activation, people have blindly changed practices without reflecting on ancient and modern medical texts. When the powder activates, they hastily take these new formulas in emergencies, failing to cure the disease and instead inviting disaster. Hanshi San has long been known as a difficult-to-manage medicine. Those who have not taken it did so out of caution. Since one seeks benefit by taking it, those who have already taken it must study methods of rescue and resolution to save themselves when it activates later. If one ingests medicines containing five stones but lacks knowledgeable rescuers at home, and instead trusts new counteractive formulas and changes practices, abandoning correctness for error, is this not wasting life and misusing medicine? Consulting the *Shennong Bencao Jing* (Divine Farmer's Materia Medica), which describes the properties and flavors of herbs and minerals, there is no mention of counteractive harmonies or specific indications of activation. Any theory of counteractive harmony is based on the *Bencao Jing*. Furthermore, the formula for Hanshi San states the main indications and annotates ingredients but does not explain the specific mechanisms of treatment or the nature of counteractive harmonies and activation. Reviewing Huangfu Mi's (courtesy name Shian, style name Shi'an) *Sanjie Shuo* (Discourse on Dissipation) and guidelines for administration and regulation, there is also no mention of counteractive harmonies or activation. Similarly, the method proposed by the Bingqiu family, using warmth to treat discoloration from drug failure, lacks such theories. If one considers opposing drug properties as miraculous, consider that Gualou (Trichosanthis Fructus) is incompatible with Ganjiang (Zingiberis Rhizoma); this is a major harm in counteractive therapy. Dao Hong discusses counteraction but fails to distinguish this point; how can his formulas be followed? I do not follow them. One should adhere to Huangfu Mi's guidelines and remove Gualou, which is beneficial. For those with heat syndromes, the original medicine should not be taken; only those with cold syndromes should take it, thus naturally excluding Gualou. For deficiency consumption and weak legs, replace Gualou with Shihu (Dendrobii Caulis) in a ratio of ten parts. For wind-cold causing rebellious Qi and cough, replace Gualou with Ziwan (Asteris Radix) in a ratio of ten parts. These two methods are excellent. For miscellaneous chronic diseases, simply remove Gualou; do not add other substances.